Your heart changes in size and shape with exercise – this can lead to heart problems for some athletes and gym rats

Exercise has long been recognized by clinicians, scientists and public health officials as an important way to maintain health throughout a person’s lifespan. It improves overall fitness, helps build strong muscles and bones, reduces the risk of chronic disease, improves mood and slows physical decline.

Exercise can also significantly reduce the risk of developing conditions that negatively affect heart heath, such as high blood pressure, high cholesterol and obesity. But large amounts of exercise throughout life may also harm the heart, leading to the development of a condition called athletic heart.

As the sports cardiology director at the University of Colorado Anschutz Medical Campus, I’m often asked how much and what kind of exercise is necessary to get the benefits of exercise. Many people also wonder about the risks of exercise, and what happens if you exercise too much.

The American Heart Association generally recommends 150 minutes of moderate-intensity exercise, such as brisk walking, or 75 minutes of vigorous-intensity exercise, such as running, each week. It also recommends muscle strengthening exercises at least twice per week.

When people exceed these guidelines, the heart may remodel itself in response – that is, it begins to change its size and shape. As a result, heart function may also change. These changes in heart structure and function among people who engage in high levels of exercise are referred to as the athletic heart, or athlete’s heart. Athletic heart doesn’t necessarily cause problems, but in some people it can increase the risk of certain heart issues.

What is athletic heart?

To understand how exercise affects the heart, it’s important to consider what kind of exercise you’re participating in.

Exercise is generally divided into two broad categories: dynamic and static.

Dynamic exercises, like running, cross-country skiing and soccer, require the heart to pump an increased amount of blood, compared to the amount delivered to the body at rest, in order to sustain the activity. For example, when running, the amount of blood the heart pumps to the body may increase by threefold to fivefold compared to at rest.

Static exercises, like weightlifting, gymnastics or rock climbing, require the body to use skeletal muscle in order to push or pull heavy amounts of weight. While the heart does pump more blood to skeletal muscles that are working during these activities, these kinds of exercises depend on a muscle’s ability to move the weight. For example, in order to do curls with dumbbells, the biceps must be strong enough to lift the desired weight.

Close-up of lower half of the back of a person cycling, one hand outstretched towards the vegetation on the side of the road

Cycling involves both dynamic and static exercise.
Judit Murcia/Unsplash, CC BY-SA

Some exercises, like rowing or cycling, are both highly dynamic and highly static because they require the heart to pump large amounts of blood while simultaneously requiring a large amount of muscle strength to sustain…

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